Diffusion and magnetization transfer MRI of brain infarct, infection, and tumor in children

The purpose of this study was to determine the efficacy of diffusion-weighted imaging (DWI) and magnetization transfer imaging (MTI) in the differential diagnosis of brain infarct, infection, hamartoma, and tumor in 106 children. The apparent diffusion coefficients (ADCs) and magnetization transfer ratios (MTRs) of the lesions were compared using nonparametric tests. There was an inverse relationship between ADC and MTR in subacute/chronic infarct, infection, hamartoma, arachnoid cyst, and tumor relative to normal brain parenchyma. Both ADC and MTR were reduced in acute infarct. DWI and MTI had a complementary role in the differential diagnosis of acute infarct from infection with lower MTR, from hamartoma with higher ADC, and from low-grade gliomas and benign tumors that had higher ADCs and lower MTRs. ADCs increased and MTRs decreased with the duration of infarct and lower tumor grade.